PERCUTANEOUS ENDOSCOPIC LUMBAR DISCECTOMY SURGERY

Percutaneous Endoscopic Lumbar Discectomy Surgery In India

Percutaneous endoscopic lumbar discectomy is the ultimate form of minimal invasive spine surgery. In this form of surgery, an instrument called endoscope is used. Whole surgery is done under local anesthesia and patient is fully awake during surgery. In fact for successful surgery patients active participation is necessary.

Patient is made to lie prone on operation table and exact entry point is mapped on patients body using image intensifier x-ray system. A long spinal needle is passed from side of back which goes into disc directly by-passing other bone and ligaments. Through this needle guide wire is passed and after taking 5mm incision, dilator and working cannula are passed under local anesthesia., through which endoscope is passed. Camera and monitor is attached to endoscope and prolapsed part of disc is removed under vision. Wound is closed with single stitch. Patient gets immediate pain relief and he can go home in 24 hrs and can resume his work soon.

What Are Some Of The Reasons I Might Need A Posterior Cervical Laminectomy & Discectomy?

This Surgery Is Usually Recommended To Address Problems Of : –

1. Herniated Nucleus Pulposus
2. Bone Spurs
3. Foraminal Stenosis
4. The main reason for this surgery is pressure on a nerve going to the arm.
5. Cervical cord compression causing myelopathy (weakness in arms and legs).

How Is The Surgery Done?

An incision is made at the back of the neck, and the muscles pulled to one side. The lamina (the “roof” of the spine) may be removed in order to decompress the spinal cord, or only the part of the lamina may be removed that is over the foramen where the nerve roots are being trapped. A foraminotomy, making more room for the nerve root, or a discectomy, removing protruding part of the disc or disc fragments, may be done to relieve pressure on a nerve. The muscles are released and the incision is closed.

The cervical spine begins at the base of the skull and supports the weight of the head. The spinal cord runs from the brain down through the cervical spine, controlling the function of the body’s organs and limbs. In between each of the 7 vertebrae of the cervical spine are soft pads or discs which act as shock-absorbers and allow for bending and movement of the head. Each disc is made up of two parts, a soft center called the nucleus and a tough outer band called the annulus.

Risks

There is a 90% satisfaction outcome from cervical laminectomies and discectomies. Complications are rare, but you need to be advised that they can occur.

Some Possible Complications Are : –

1. Pain, numbness, and clumsiness could occur even if the surgery is correctly done.
2. There could be impaired muscle function or paralysis which is temporary or permanent.
3. Incontinence or impotence could occur. This refers to loss of bowel, bladder or sexual function.
4. Unstable spine is a possibility. Sometimes, in order to resolve the problem, so much bone is removed that the spine is left with weakness or instability. If there is not enough bone left to provide the appropriate amount of stability, it might be necessary in the future to contemplate having a spinal fusion which is a more extensive surgical procedure to reconstruct the weakness in the bones.

Advantages in India

• Surgery done under local anesthesia with conscious sedation
• 5 mm skin incision
• Endoscope used for surgery
• No muscle, ligament or normal tissue damage
• Targeted fragmentectomy. (directly prolapsed disc tissue removed.)
• Minimal blood loss
• Patient can be discharged in 24 Hrs.
• No prolonged bed rest required after surgery. Can resume work sooner.
• Even prolapsed, migrated, extra-foraminal, recurrent discs can be removed. Very good technique for old and medically compromised patients.